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篇名
血液腫瘤病患人工血管照護品質改善專案
並列篇名
Hematology-Oncology Port-A: Improving Nursing Care Quality
作者 陳怡蓉顏慶雲
中文摘要
背景:血液腫瘤病患裝置人工血管以利化學治療,卻易血流感染影響預後。護理因其獨特地位得成為醫療團隊領導角色,藉由高品質護理、執行需要的改變,以預防人工血管血流感染並改善病人照護成效。2008年7月至2009年6月,本單位發生12件人工血管血流感染案例,感染率3.18‰。經現況分析發現主要原因為:(1)護理人員人工血管照護知能不足;(2)人工血管護理技術標準及敷料更改;(3)病患及家屬人工血管自我照護不足。因而成立專案小組進行改善。目的:本專案旨在提昇護理人員執行人工血管照護品質,以降低病患血流感染率。解決方案:於2009年8月15日至2009年12月20日執行改善策略,包含:(1)修訂人工血管護理技術標準;(2)更換敷料型號;(3)執行不定期技術稽核;(4)舉辦人工血管護理教育訓練;(5)統一病患及家屬對人工血管的自我照護指導標準。結果:血液腫瘤病患人工血管血流感染率由3.18‰降至0.99‰,下降率68.87%。結論:本專案有效降低人工血管血流感染率、提升病患安全及臨床照護品質,可作為同儕單位照護血液腫瘤病患之參酌。
英文摘要
Background: Hospitalized hematology-oncology patients undergoing chemotherapy face a significant risk of port-A related bloodstream infections. Nurses are uniquely positioned to help adjust clinical practices necessary to prevent port-A related bloodstream infections and improve patient outcomes. Between July 1st, 2008 and June 30th, 2009, twelve patients in our ward were stricken with port-A related bloodstream infections (an infection rate of 3.18‰). Data analysis indicated inadequate nursing competency in all aspects of port-A care. Nurses did not have adequate knowledge of port-A modified standard care protocols and did not provide dressings suited to hematology-oncology patient needs. Also, both patients and caregivers lacked adequate skin care knowledge. Our team developed a project to address and minimize port-A related bloodstream infection issues in our hospital.Objects: The authors designed this project to enhance integration of both the central line insertion care and maintenance practice bundles in order to reduce port-A related bloodstream infection incidence.Resolution: The plan was implemented from August 15, 2009 to December 20, 2009. It included establishing a standardization port-A care protocol, implementing a more appropriate dressing type, performing an irregular audit of port-A care techniques, holding educational training, and establishing skin care instructions for patients and their families.Results: Hematology-oncology patient port-A related bloodstream infections fell from 3.18‰ pre-implementation to 0.99‰ post-implementation. The effective rate of improvement was 68.87%.Conclusion: Standardization of Port-A care under this project achieved infection reduction results that achieved our anticipated goals. This project furthermore enhanced the delivery and quality of patient nursing services. This experience can serve as a reference to medical organizations involved in hematology-oncology patient care.
起訖頁 64-72
關鍵詞 照護品質血液腫瘤人工血管血流感染Nursing care qualityhematology-oncologyPort-Abloodstream infections
刊名 護理雜誌  
期數 201106 (58:3附冊期)
出版單位 臺灣護理學會
該期刊-上一篇 降低外科加護病房病人壓瘡發生率之專案
該期刊-下一篇 運用ADOPT問題解決模式於一位兩次透析間體重控制不佳的血液透析個案
 

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